To: The Treasurer, UKCCOA

Mr. B Brown 20 Coronation Rd Burnham on Crouch Essex CM0 8HW

I would like:

___ T Shirts at £10 each

___ Hoodies at £20 each

___ DVDs at £15 each

___ Sail numbers at £25 each

Name      __________________________  Date      __________________________

Address   __________________________  

          __________________________  

          __________________________  

          __________________________  

Telephone __________________________  

Mobile No __________________________

Email     __________________________

I enclose a cheque made payable to "Cherub Class Owners Association (UK)" for £____ for the above.
I ackowledge that this form is an order for goods for which I must pay.
I understand that delivery of items may not be immediate.

Signed    __________________________